Aspirin to treat aggression? The evidence isn't there yet
Headlines claiming aspirin can
treat 'intermittent explosive disorder' are going beyond the evidence
available, and might even put people at risk
Friday 20 December 2013
Regular aspirin use can increase the risk of bleeding in the brain or
stomach, and there’s not enough evidence to advise healthy people to take it
daily. Photograph: Alamy
The Telegraph front page on
Thursday reported that aspirin could be a cure for intermittent explosive
disorder. IED, characterised by bouts of extreme and disproportionate rage, is
thought to affect 2-3% of the population of the USA, according to the research
paper.
It’s a pretty serious disorder,
not to be confused with mere ‘bad behaviour’. These are impulsive,
hard-to-control aggressive outbursts, and the condition is linked to a number
of other adverse health outcomes.
But can aspirin really cure it? I
went to the study in question and had a look. For a start, there’s no mention
of aspirin, or any anti-inflammatory drug, anywhere in the peer-reviewed
article.
The scientific research looks at
the relationship between aggression, in particular IED symptoms, and levels of
two inflammatory markers found in blood plasma – C-reactive protein, and
interleukin 6. The study is a case-control design, which means people are
chosen to be included in the study because of their aggression status.
They recruited fewer than 200 people,
which for studies of this design is quite a small number, and then further
split these people into three groups to compare. People with IED are likely to
be different from people without it in a number of ways, so usually for
observational studies like this you’d want a larger sample size.
Not only this, but the measures of
aggression and the measures of inflammatory marker levels were taken at the
same time as each other. This means that even if an association between the two
is seen, as it was here, there is no way of knowing the direction of causation.
Aside from the possibility that
the association seen is due to other differences between people with or without
IED, it could be that aggression leads to rises in inflammatory markers, or
that increases in these markers lead to an increase in IED. If the former is
true, then no amount of aspirin would help, as causation is the wrong way
round.
Which brings me to my next
question: can aspirin actually change the levels of these markers? Evidence suggests
not. The main marker investigated is C-reactive protein (also known as CRP).
Because it is relatively easy to measure, and stability in level, it’s often
used as a marker of inflammation, with rises in levels associated with diseases
such as diabetes, cardiovascular disease and potentially even some cancers.
However, there’s very little
evidence that aspirin can change levels of CRP. Although this study suggests
that aspirin might differentially affect risk for unstable angina depending on
CRP levels, the levels themselves weren’t greatly affected by aspirin use.
Other studies have found no effect on CRP levels after aspirin use.
Also, it’s important to remember
that aspirin is not a harmless drug. In fact a recent review suggests that for
healthy people, there’s not enough evidence that the potential benefits would
outweigh the risks of daily aspirin. Regular aspirin use can increase health
risks such as bleeding in the brain or stomach, and as yet there’s not enough
evidence to advise healthy people to take aspirin as regularly as daily.
For a newspaper to suggest that
aspirin could treat this disorder, a claim that wildly extrapolates from the
findings they are referring to, is not only misleading in terms of the findings
of the research, but also potentially could harm people who might think they
should begin self-medicating with aspirin.
Bayer AG
Bayer AG
Bayer AG (/ˈbaɪər/; German pronunciation: [ˈbaɪ̯ɐ]) is a German chemical and pharmaceutical company founded
in Barmen (today a part of Wuppertal), Germany in
1863. It is headquartered in Leverkusen, North
Rhine-Westphalia, Germany
and well known for its original brand of aspirin. Bayer marketed heroin in 1895
and invented aspirin in 1897. The company was 150 years old on 1 August 2013.
History
The Bayer company then became
part of IG Farben, a German chemical company conglomerate. During World War II,
the IG Farben used slave labor in factories attached to large slave labor
camps, notably the sub-camps of the Mauthausen-Gusen concentration camp.[3] IG
Farben owned 42.5% of the company that manufactured Zyklon B,[4] a chemical
used in the gas chambers of Auschwitz and other extermination camps. After
World War II, the Allies broke up IG Farben and Bayer reappeared as an
individual business. The Bayer executive Fritz ter Meer, sentenced to seven
years in prison during the IG Farben Military Tribunal at Nuremberg, was made head of the supervisory
board of Bayer in 1956, after his release.
Note: Klaus Kleinfeld is a director at Bayer AG, a trustee at the Brookings Institution (think tank), a
director at the American Friends of Bilderberg
(think tank), and a 2008 Bilderberg conference participant (think tank).
Foundation
to Promote Open Society was a funder for the Brookings Institution
(think tank), and the Committee for
Economic Development.
George Soros
is the chairman for the Foundation to Promote Open Society.
Robert
A. Helman was an honorary trustee at the Brookings Institution (think
tank), is a partner at Mayer Brown,
and a member of the Commercial Club of Chicago.
Commercial Club of Chicago,
Members Directory A-Z (Past Research)
Tuesday, December 17, 2013
William
M. Daley was a partner at Mayer
Brown, the chief of staff for the Barack
Obama administration, and is a member of the Commercial Club of Chicago.
William M. Daley
Professional career
Daley returned to the practice of
law, as a partner with the firm Mayer Brown (then Mayer, Brown & Platt)
from 1993 to 1997.
Mayer
Brown was the lobby firm for the Bayer
Corporation.
Bayer
Corporation is the North American subsidiary of Bayer AG.
Bayer HealthCare
is a subsidiary of Bayer AG.
Sidley Austin
LLP is the lobby firm for Bayer
HealthCare.
R.
Eden Martin is counsel at Sidley
Austin LLP, and the president of the Commercial
Club of Chicago.
Michelle
Obama was a lawyer at Sidley Austin
LLP.
Barack
Obama was an intern at Sidley Austin
LLP.
Newton
N. Minow is a senior counsel at Sidley
Austin LLP, and a member of the Commercial
Club of Chicago.
W. James
McNerney Jr. is a member of the Commercial
Club of Chicago, and the chairman & president & CEO for the Boeing Company.
Barbara G. Fast
was a VP at the Boeing Company, and
a VP for the CGI Group Inc.
CGI Group Inc.
was the Obamacare contractor that
developed Healthcare.gov web site.
Obamacare
is Barack Obama’s signature policy
initiative.
Donna
S. Morea was the EVP for the CGI
Group Inc., and a trustee at the Committee
for Economic Development.
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